Treatment failure with the use of ciprofloxacin for gonorrhea correlates with the prevalence of fluoroquinolone-resistant Neisseria gonorrhoeae strains in Bangladesh

Although ciprofloxacin is one of the recommended drugs of choice for the tr eatment of gonorrhea, in vitro resistance to this drug has been observed in surveillance studies and case reports from many parts of the world, includ ing Bangladesh. However, to our knowledge, there have been no prospective s tudies of the correlation between in vitro response to the drug and treatme nt outcome. Therefore, a prospective study of 217 female sex workers in Dha ka, Bangladesh, was conducted to examine the correlation between the in vit ro response of Neisseria gonorrhoeae and the outcome of ciprofloxacin treat ment. Overall, 37.8% of the gonococcal isolates recovered from female sex w orkers were resistant to ciprofloxacin, and there was a good correlation be tween in vitro resistance and treatment failure. These findings suggest tha t in vitro resistance to ciprofloxacin is predictive of clinical treatment failure in patients with gonorrhea.